This year, the coronavirus pandemic could create the perfect winter storm, and scientists say countries need to prepare for a potential uptick in cases that could be more serious than the initial outbreak.
The Northern Hemisphere may have had a mild flu season last winter, but there is still the risk of a flu epidemic this year. Plus, the pandemic has disrupted and stretched health care in many countries, leading to a backlog of patients and exhausted frontline workers who are still reeling from the staggering number of cases so far.
“We need to do everything we can to stay healthy this winter and priority must be given to those who are most vulnerable,” said Dr. Stephen Holgate, Medical Research Council clinical professor of immunopharmacology and honorary consultant physician at the University of Southampton and chair of the report.
“We’ve got these three months where things are getting better,” he said. “This is a critical window of opportunity to help us prepare for the worst that winter can throw at us.”
Keep those windows open if you can
Being indoors more during the winter means there’s more opportunity for person-to-person transmission of viruses, the report said. Less daylight means people stay indoors for longer periods, and they’re more likely to drive or use public transport.
Poor ventilation, combined with more crowded spaces, increases the density of virus particles circulating in the air, the report said. Lower humidity, cooler temperatures and darker conditions could also mean the virus lingers longer on surfaces, it added.
“In cold, wet or windy weather people are reluctant to open windows as they create cold drafts and hence they often have lower ventilation rates in winter,” the report said.
“This can be a particular challenge in modern airtight buildings which have very low infiltration rates for energy efficiency and for people on low incomes who are trying to keep heating costs down.”
The Academy of Medical Sciences said that its models indicated that Covid-19 cases would rise again in fall and peak in January and February — the busiest time of year for the country’s National Health Service.
The figures from the Academy of Medical Sciences are based on the assumption that it won’t be possible to introduce a lockdown as effective as the one the UK imposed in March 2020. The model doesn’t take into account the use of potential new drugs, or discoveries about existing drugs such as the steroid dexamethasone, which could reduce death rates. Nor does it take into account other possible treatments or potential vaccines.
Get a flu shot
It was particularly difficult, the report said, to project how seasonal influenza would play out this winter. If often varies in severity from year to year.
It’s possible, however, to have a cold or influenza at the same time as Covid-19 — and this can increase the risk of sneezing and coughing, making it easier for Covid-19 to spread, said the Academy of Medical Sciences report.
What’s more, flu and other respiratory illnesses that share the same symptoms as Covid-19 are likely to make cases and clusters of coronavirus harder to track. The expected number of people in England and Wales alone who will meet current case definitions for Covid-19 (cough or fever or loss of sense of smell) will rise from 100,000 per day in the summer to 360,000 a day in the winter, according to the report.
One thing all experts agree on unequivocally is that as many people as possible should get the influenza vaccine.
“This fall, before the seasonal circulation of influenza increases, I encourage the American people to be prepared and to embrace flu vaccination with confidence for yourself, your families in the communities,” Dr. Robert Redfield, director of the US Centers for Disease Control and Prevention, said on June 23.
“This single act will save lives,” Redfield added.
What’s not known
It’s also hard to detect a trend from what’s happening in the Southern Hemisphere, where it’s mid-winter right now, the report said. Australia and New Zealand both reacted quickly to the threat from Covid-19 and virus transmission remains at very low levels, the report said. However, some countries in South America have seen a surge in cases.
In the United States and the UK, many students have yet to return to school, and the new academic year is a factor that typically increases the transmission of influenza. While this hasn’t been demonstrated with Covid-19, the report said schools, nurseries and universities should carefully monitor for early evidence of a resurgence in cases.
In addition to flu shots, the Academy of Medical Sciences recommended a public information campaign as well as tailored advice for at-risk groups. It also emphasized ensuring test and trace programs are working properly and can cope with overlapping symptoms of flu and other winter infections.
It stressed its forecasts weren’t a prediction but a possibility.
“The modeling suggests that deaths could be higher with a new wave of Covid-19 this winter, but the risk of this happening could be reduced if we take action immediately,” Holgate said.